Efficacy and safety of first-line bevacizumab (BEV) plus interferon-α2a (IFN) in patients (pts) ≥65 years with metastatic renal cell carcinoma (mRCC)

Bajetta, E.; Ravaud, Alain; Bracarda, Sergio; Négrier, S.; Szczylik, Cezary; Molins, Joaquim Bellmunt; Moore, N.; Pisa, Pavel; Escudier, Bernard

doi:10.1200/jco.2008.26.15_suppl.5095

Cited by 17 publications

(11 citation statements)

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“…One additional clinical trial was identified in the re-run search. A total of 11 publications were therefore included in the review; these relate to three clinical trials reported in the full-text publications (Motzer et al, 2007b;Escudier et al, 2008;Rini et al, 2008) and eight conference abstracts (Motzer et al, 2006(Motzer et al, , 2007a(Motzer et al, , 2007cBracarda et al, 2007;Escudier et al, 2007;Melichar et al, 2007;Bajetta et al, 2008;Figlin et al, 2008) Figure 1 Flow chart of trial selection process.…”

Section: Quantity Of Evidencementioning

confidence: 99%

Sunitinib and bevacizumab for first-line treatment of metastatic renal cell carcinoma: a systematic review and indirect comparison of clinical effectiveness

et al. 2009

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BACKGROUND: Two new agents have recently been licensed for use in the treatment of metastatic renal cell carcinoma (RCC) in Europe. This paper aims to systematically review the evidence from all available randomised clinical trials of sunitinib and bevacizumab (in combination with interferon-a (IFN-a)) in the treatment of advanced metastatic RCC. METHODS: Systematic literature searches were performed in six electronic databases. Bibliographies of included studies were searched for further relevant studies. Individual conference proceedings were searched using their online interfaces. Studies were selected according to the predefined criteria. All randomised clinical trials of sunitinib or bevacizumab in combination with IFN for treating advanced metastatic RCC in accordance with the European licensed indication were included. Study selection, data extraction, validation and quality assessment were performed by two reviewers with disagreements being settled by discussion. The effects of sunitinib and bevacizumab (in combination with IFN-a) on progression-free survival were compared indirectly using Bayesian Markov Chain Monte-Carlo (MCMC) sampling in Win BUGS, with IFN as a common comparator. RESULTS: Three studies were included. Median progression-free survival was significantly prolonged with both interventions (from approximately 5 months to between 8 and 11 months) compared with IFN. Overall survival was also prolonged, compared with IFN, although the published data are not fully mature. Indirect comparison suggests that sunitinib is superior to bevacizumab plus IFN in terms of progression-free survival (hazard ratios 0.796; 95% CI 0.63 -1.0; P ¼ 0.0272). CONCLUSION: There is evidence to suggest that treatment with sunitinib and treatment with bevacizumab plus IFN has clinically relevant and statistically significant advantages over treatment with IFN alone in patients with metastatic RCC.

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Section: Quantity Of Evidencementioning

confidence: 99%

Sunitinib and bevacizumab for first-line treatment of metastatic renal cell carcinoma: a systematic review and indirect comparison of clinical effectiveness

et al. 2009

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“…Another retrospective analysis of the results obtained from AVOREN study showed that patients aged ≥65 treated with bevacizumab plus interferon-α (IFN-α) obtained a similar benefit in terms of PFS to patients aged <65 years (HR, 0.77 vs 0.54, respectively) [12]. Older patients experienced a higher incidence of fatigue and asthenia, but these were not dose-limiting AEs.…”

Section: Treatment Of Frail And/or Elderly Patientsmentioning

confidence: 98%

Update from the Spanish Oncology Genitourinary Group on the treatment of advanced renal cell carcinoma: focus on special populations

Calvo¹,

Maroto

Muro

et al. 2010

Cancer Metastasis Rev

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Elderly or frail patients are often excluded from clinical trials. As a result, clinical outcome of these patients may differ from those obtained in trials. This situation may also hold true for patients who have severe concomitant diseases such as renal, hepatic, or cardiac dysfunction. Being aware of the wide range of clinical situations that a specialist may face is important to ensure that under any circumstances, the patient will receive the best treatment possible. The Spanish Oncology Genitourinary Group issued its first public statement on recommendations for the optimal management of advanced renal cell carcinoma (RCC). However, some issues remained unsolved. In this report, we discuss the current role of Medical Oncology in the treatment of patients with advanced RCC and review the management of special patient populations, such as elderly or patients with concomitant diseases.

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“…Elles concernent de petits effectifs, sans é valuation oncogé riatrique spé cifique. Cependant, malgré les ré serves dues aux analyses de sous-groupes (â ge mé dian proche de 60 ans), elles semblent en faveur de l'utilisation au moins des ITK du VEGFR dans cette population qui en bé né ficierait comme les sujets jeunes [2,5,9]. La dé cision de la mise en place d'un traitement doit, malgré tout, reposer sur l'é valuation du ratio bé né fice/risque plus que sur l'â ge civil.…”

Section: Mé Tastases Cé Ré Bralesunclassified

“…La majorité des é tudes é valuant les nouvelles molé cules inclut des patients porteurs de RCC à l'exclusion des autres histologies notamment papillaires (CRPap) et chromophobes (CRCh) [2,11,23,25,28]. À ce jour, il n'existe pas de traitement standard validé pour les cancers du rein non à cellules claires (CRNCC).…”

Section: Cancers Du Rein Papillaires Et Chromophobesunclassified

Stratégie de la prise en charge médicale dans les stades métastatiques

2009

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Efficacy and safety of first-line bevacizumab (BEV) plus interferon-α2a (IFN) in patients (pts) ≥65 years with metastatic renal cell carcinoma (mRCC)

Cited by 17 publications

References 0 publications

Sunitinib and bevacizumab for first-line treatment of metastatic renal cell carcinoma: a systematic review and indirect comparison of clinical effectiveness

Sunitinib and bevacizumab for first-line treatment of metastatic renal cell carcinoma: a systematic review and indirect comparison of clinical effectiveness

Update from the Spanish Oncology Genitourinary Group on the treatment of advanced renal cell carcinoma: focus on special populations

Stratégie de la prise en charge médicale dans les stades métastatiques

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